September 20, 1919


JAMA. 1919;73(12):913. doi:10.1001/jama.1919.26120380001012

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Is it not surprising how many cesarean sections are being performed by the younger class of obstetric surgeons? An obstetric surgeon reports that, though he has not been in practice more than ten years, he has already passed his one hundred and fiftieth cesarean section. It may be questioned whether the conditions warrant the operation. Has not nature perfected the proper way for normal birth?

Cesarean section is justifiable only when the following conditions are present; contracted, deformed or diseased pelvis; placenta praevia; eclampsia; fibroid tumor; kyphosis; osteosarcoma of the pelvis; hypertrophic elongated cervix; uterine fibroma; malignant disease of the cervix uteri; face presentation with chin directly posterior; funnel pelvis; inoperable carcinoma of the uterus; presentation of the head, cord and foot; atresia of the vagina; deformities of fetus of abnormal development, including the hydrocephalic fetus; ruptured uterus; hydramnios; suppurating ovarian cyst; double uterus; adherent placenta and ruptured uterus; Bright's

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